Lemon balm (Melissa officinalis) is an herb that grows in southern Europe. Lemon balm is believed to have sedative, anti-gas, fever-reducing, antibacterial, spasm-reducing, blood pressure-lowering, memory-enhancing, menstruation-inducing, and thyroid-related effects, and it is thought by some to be an herbal cure-all. Research suggests that lemon balm may contain high levels of antioxidants.

Lemon balm is a member of the Lamiaceae family, which also includes dittany, mint, sage, siderites, and sweet marjoram.

Research appears to support the use of lemon balm applied directly to the skin to manage herpes infection symptoms. Lemon balm has also been studied for a number of medical conditions, including anxiety, stomach lining inflammation, and irritable bowel syndrome. While some early findings have indicated promise, more studies are needed before conclusions can be made.

No serious side effects have been associated with lemon balm, although research on long-term use is limited.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Research suggests that lemon balm applied to the skin may effectively treat symptoms of herpes simplex infections. Lomaherpan®, a 1% dried lemon balm extract cream, has been used in most studies. While results are promising, further research is required to confirm the effects of lemon balm.

B

Research has found that lemon balm aromatherapy may help reduce stress and agitation in people with dementia. Although findings are promising, more research is needed to better understand these effects.

C

Early research supports the use of lemon balm for anxiety. Although results are positive, more research is needed before conclusions can be made.

C

A combination treatment containing lemon balm has been studied in the treatment of infant colic. Early research suggests that it may be an effective treatment for this condition. Although results are promising, more studies are needed.

C

There is limited evidence suggesting that a combination herbal treatment that includes lemon balm may be effective in the treatment of colitis. However, more research is needed.

C

There is a lack of evidence to show that a combination lemon balm treatment may be effective in treating depression. More research in this area is needed.

C

Early evidence suggests that combination products containing lemon balm may reduce indigestion. However, more research is needed before conclusions can be drawn.

C

Lemon balm-containing treatments have been used for stomach pain, discomfort, and bloating. While some results are positive, more studies looking at the effects of lemon balm alone are needed to determine its effectiveness.

C

There is limited evidence to support the use of lemon balm in treating mental disorders. More high-quality trials are needed before any firm conclusions can be drawn.

C

Some studies found that lemon balm extract may affect mood and cognition. More research is needed to better assess the effectiveness of this treatment.

C

There is limited evidence supporting the use of lemon balm to treat restlessness in children. More research is needed before conclusions can be made.

C

There is a lack of high-quality evidence supporting the use of lemon balm as a sleep aid. Most studies have used lemon balm in combination products. More research is needed to determine the potential sedative effects of lemon balm alone.

C

Early research suggests that an herbal combination product containing lemon balm may reduce anxiety and depression associated with somatoform disorder. More research is needed before any conclusions can be made.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

A common dose of lemon balm is one cup of tea taken by mouth several times daily as needed. Some evidence suggests using 1.5-4.5 grams of lemon balm herb in tea by mouth several times daily. A dose of 2-6 milliliters three times daily has been taken by mouth. A dose of 8-10 grams of lemon balm leaves has been taken by mouth daily. Single doses of 300 milligrams, 600 milligrams, and 900 milligrams of lemon balm extract have been studied.

For agitation in dementia, a lotion containing lemon balm essential oils has been applied directly to the hands and face twice daily. 1 milliliter of lotion containing 100 milligrams of melissa oil has been massaged into the hands and upper arms for 1-2 minutes twice daily for 12 weeks.

For anxiety and sleep quality, the product, Cyracos®, has been taken by mouth for 15 days. Information on dosing is unavailable at this time.

For mental performance, 60 drops of lemon balm extract have been taken by mouth daily. Doses of 600, 1,000, and 1,600 milligrams of dried leaf capsules (Pharmaton) have been taken by mouth at weekly intervals.

For symptoms of herpes simplex virus infections, a cream containing 1% lemon balm extract has been applied directly to the skin up to five times daily for 14 days. A tea containing lemon balm (prepared by steeping 2-3 grams of lemon balm leaf in 150 milliliters of boiling water for 5-10 minutes and then straining) has been applied to herpes lesions with a cotton ball several times daily.

Children (under 18 years old)

For anxiety in children aged 6-7 years, 3-6 milligrams of M. officinalis extract per kilogram have been taken by mouth.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in people who have a known allergy or sensitivity to lemon balm, any of its parts, or other plants of the genus Melissa. Allergic reactions have been reported, including burning sensation, contact dermatitis, prickling sensation, and skin irritation and reddening.

Side Effects and Warnings

Lemon balm is likely safe when applied to the skin or taken by mouth in recommended doses (up to 30 days) in otherwise healthy adults and when consumed in amounts normally found in foods. Lemon balm is well tolerated when taken by mouth for up to eight weeks. Research found minimal side effects associated with applying lemon balm to the skin for up to 10 days. Lemon balm has been given Generally Regarded as Safe (GRAS) status in the United States, with a maximum level of 0.5% in baked goods.

Lemon balm may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Lemon balm may cause low blood pressure. Caution is advised in people taking drugs or herbs and supplements that lower blood pressure.

Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery. Lemon balm may increase the sedative effects of alcohol.

Use cautiously in people who have autoimmune disorders or who are taking agents that may affect immune system function.

Use cautiously in people who are taking central nervous system (CNS) depressants or selective serotonin reuptake inhibitors (SSRIs).

Use cautiously in people who have glaucoma, as lemon balm may increase eye pressure.

Use cautiously in people who have heart conditions, as lemon balm may reduce heart rate.

Use cautiously in people with thyroid disorders, as lemon balm may interfere with thyroid hormone replacement therapy.

Use cautiously in people taking antiangiogensis agents (preventing blood vessel growth), as lemon balm has shown to inhibit blood vessel growth in in animal research.

Avoid in pregnant or breastfeeding women, due to a lack of safety data and a possible connection between lemon balm and lead contamination.

Avoid in people who have a known allergy or sensitivity to lemon balm, any of its parts, or other plants of the genus Melissa. Allergic reactions have been reported, including burning sensation, contact dermatitis, prickling sensation, and skin irritation and reddening.

Pregnancy and Breastfeeding

Avoid in pregnant or breastfeeding women, due to a lack of safety data and a possible connection between lemon balm and lead contamination.

Lemon balm may increase the amount of drowsiness caused by alcohol and some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

Lemon balm may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Lemon balm may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Lemon balm may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Lemon balm may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

Lemon balm may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the cytochrome P450 system.

Lemon balm may increase the amount of drowsiness caused by some herbs or supplements.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.